Coping With Mass Casualties from a Nursing Standpoint

by Howard Gerber on June 6, 2013

Having mass casualties arrive at the hospital you work in can be one of the most challenging times for a nurse. Mass casualty incidents may be any type of disaster or situation that involves a sudden influx of patients. For instance, mass casualty incidents may include natural disasters, such as floods, tornadoes, and hurricanes. Vehicle pileups, fires, and shootings can also result in multiple patients.

All hospitals should have a policy for dealing with mass casualty incidents. Some hospitals will have drills occasionally to help staff practice how they would handle a situation with a sudden increase in patients.

There are many variables when it comes to dealing with mass casualty incidents. Hospital supervisors will need to consider the nature of the incident, which may give insight into the type of injuries that will likely need to be treated. The number of patients the hospital will take is also an important factor to consider.

From a nursing standpoint, it is essential to remain calm and not to let emotions interfere with duties. While it is normal to have a reaction to a tragedy, while you are working your shift is not the time to break down. If you are faced with a mass casualty incident, you’ll need to take a deep breath and stay focused on your job responsibilities.

One of the key things to remember is to prioritize. While you always do some prioritizing on the job, when multiple patients are being admitted knowing how to prioritize is essential. Rely on your assessment skills and teamwork to get through the triage process.

Keep in mind, you may need to work quickly, but not so fast you get sloppy or make mistakes. For instance, hospital polices still need to be followed for administering medication and charting. Remember the basics still apply. For example, treat patients respectfully even if you are feeling stressed. Patients may be in shock, scared, or confused. Be sure to use clear communication to patients to help them understand what is going on.

If things get very busy, they can become chaotic. Clarify orders if you don’t understand something. Even if something is not your regular responsibility if it is in your scope of practice, pitch in where you can.

After patients are taken care of and you have some downtime, be sure to deal with your own emotions. Some hospitals may have a debriefing after the incident. This allows workers to talk about what worked well for the hospital during the incident and what could be improved. It also gives you a chance to talk about your feelings if needed. If your hospital does not offer debriefings, a chaplain or social worker may be available to talk. Watch for signs of stress after a traumatic incident, such as sleeping or eating problems, depression and trouble concentrating. Don’t hesitate to get help if needed.

Mass causality incidents are never easy. In fact, they can be one of the most challenging experiences of your nursing career. Using your skills and remaining professional can help you effectively deal with the situation. Knowing you are helping people in a situation, which is probably one of the most difficult times of their lives, can make the challenges worth it.